阻塞性睡眠呼吸暂停低通气综合征患者的认知功能特点及影响因素研究

Study on Cognitive Function of Patients with Obstructive Sleep Apnea Hypopnea Syndrome and Its Influencing Factors

目的采用中文修订版的蒙特利尔认知评估量表(MoCA)研究阻塞性睡眠呼吸暂停低通气综合征(OSAHS)的认知功能特点及影响因素。方法选择46例OSAHS患者和44例正常人作为研究对象,比较两组MoCA检出异常率、总分、各项评分有无差异。从OSAHS的睡眠模式、呼吸紊乱指数(AHI)、最低和平均血氧饱和度的改变以及受教育程度等分析影响因素。结果 OSAHS组MoCA检出异常率(47.82%)明显高于正常对照组(8.69%)(P<0.05),总分明显低于正常对照组(P<0.05)。OSAHS主要表现在画钟实验和延迟记忆方面受损明显,觉醒指数增加,睡眠效率降低。AHI与最低、平均血氧饱和度呈负相关。受教育程度与MoCA总分呈正相关。结论 OSAHS患者认知功能减退可能与长时间反复低氧血症、睡眠结构紊乱有关。受教育程度是影响MoCA结果的因素之一。

Objective To study the cognitive function features of patients with obstructive sleep apnea hypopnea syndrome（OSAHS） and influencing factors through modified Chinese version of Montreal Cognitive assessment（MoCA）.Methods 46 OSAHS patients and 44 healthy subjects were involved into the study.The differences of abnormal ratio,total score and each item score of MoCA between the two groups were compared.The influencing factors of cognitive function including variation of sleep mode,apnea-hypopnea index（AHI）,the lowest and mean oxygen saturation and education level were analyzed.Results The MoCA abnormality rate of OSAHS group（47.82%） showed statistically significant difference compared with that of the control group（8.69%）（P0.05）.The MoCA total score of OSAHS group also showed statistically significant difference compared with control group（P0.05）.Patients in OSAHS group showed significant damage in clock drawing test and delayed memory with increased arousal index and reduced sleep efficiency.AHI was negatively correlated with the lowest and mean oxygen saturation.Education level was positively correlated with MoCA total score.Conclusion Cognitive decline in patients with OSAHS may relate to repeated hypoxemia and sleep disorder.Education level is one of the key factors influencing the results of MoCA.